National governments, non-governmental organisations,academics, and civil society need to consider what the appropriate role of the private sector will be in NCD [Non-Communicable Disease] prevention and control.

Although there is now consensus that the tobacco industry’s conflict of interest with public health is irreconcilable, whether the competing interests of the alcohol, food, and drink industries are similarly irreconcilable is debated.

The science of the effect of corporate behaviour on health is an emerging area of public health that needs to be developed substantially; it studies the health risks of transnational corporations and the distribution of the unhealthy commodities that they make and market.

In industrial epidemics, the vectors of spread are not biological agents, but transnational corporations. Unlike infectious disease epidemics, however, these corporate disease vectors implement sophisticated campaigns to undermine public health interventions. To minimise the harmful effects of unhealthy commodity industries on NCD prevention, we call for a substantially scaled up response from governments, public health organisations, and civil society to regulate the harmful activities of these industries.

Ultra-processed products

Ultra-processed products are made from processed substances extracted or refined from whole foods—eg, oils, hydrogenated oils and fats, flours and starches, variants of sugar, and cheap parts or remnants of animal foods—with little or no whole foods. Products include burgers, frozen pizza and pasta dishes, nuggets and sticks, crisps, biscuits, confectionery, cereal bars, carbonated and other sugared drinks, and various snack products. Most are made, advertised, and sold by large or transnational corporations and are very durable, palatable, and ready to consume,which is an enormous commercial advantage over fresh and perishable whole or minimally processed foods. Consequently, their production and consumption is rising quickly worldwide. In the global north—ie, North America and Europe—ultra-processed products have largely replaced food systems and dietary patterns based on fresh and minimally processed food and culinary ingredients that have less fat, sugar, and salt. In the global south —ie, Asia, Africa, and Latin America— ultra-processed products are displacing established dietary patterns, which are more suitable socially and environmentally. Ultra-processed products are typically energy dense; have a high glycaemic load; are low in dietary fibre, micronutrients, and phytochemicals; and are high in unhealthy types of dietary fat, free sugars, and sodium.When consumed in small amounts and with other healthy sources of calories, ultra-processed products are harmless; however, intense palatability (achieved by high content fat, sugar, salt, and cosmetic and other additives), omnipresence, and sophisticated and aggressive marketing strategies (such as reduced price for super-size servings), all make modest consumption of ultra-processed products unlikely and displacement of fresh or minimally processed foods very likely. These factors also make ultra-processed products liable to harm endogenous satiety mechanisms and so promote energy overconsumption and thus obesity.

The consumption of energy-dense ultra-processed foods, unlike low energy foods such as fruits and vegetables, promotes obesity. Similarly, consumption of sugar-sweetened beverages is associated with increased rates of obesity and diabetes,childhood obesity,long-term weight gain, and cardiovascular disease. In addition to the deaths caused by tobacco and alcohol, more than 18 million deaths every year are caused by high blood pressure (9·4 million), high body-mass index (3·4 million), high fasting blood glucose (3·4 million), and high total cholesterol (2·0 million),much of which could be attributed to the consumption of ultraprocessed foods and drinks.

Almost all growth in the foreseeable future in profits from the sale of these unhealthy commodities will be in low-income and middle-income countries. Saturation of markets in high-income countries and the high global average of income that people spend on food (20%) has caused the alcohol and ultra-processed food and drink industries to rapidly penetrate emerging global markets, as the tobacco industry has done. Transnational corporations are major drivers of the acceleration
of the nutrition transition—i.e., from traditional diets of whole or minimally processed foods to highly processed foods and drinks. The substantial growth of ultra-processed products has paralleled and contributed to the increase in obesity, diabetes, and other diet-related chronic diseases,especially in low-income and middle-income countries.

In the USA, the ten largest food companies control more than half of all food sales. Worldwide, this proportion is about 15% and is rising rapidly.

Strategies by industry to undermine effective public health policies and programmes:

Industry documents released because of tobacco and asbestos litigation show how these industries affect public health legislation and avoid regulation with both hard power (ie, building financial and institutional relations) and soft power (ie, influence of culture, ideas, and cognitions of people, advocates, and scientists). There is now evidence to show that the food, drink, and alcohol industries use similar tactics and strategies to the tobacco companies to undermine public health interventions.

The first strategy is to bias research findings. For example, Philip Morris International implemented the Whitecoat project to hire doctors to publish ghostwritten confounder studies purporting to negate links between environmental tobacco smoke and harm. The tobacco companies created quasi-independent organisations to publish biased and partial scientific reports, deny harm, and suppress health information. Similarly, funding from transnational food and beverage corporations biases research. A meta-analysis of research publications showed systematic bias from industry funding, with articles sponsored exclusively by food and drinks companies four-times to eight-times more likely to have conclusions favourable to the financial interests of the sponsoring company than those that were not sponsored by food or drinks companies. The International Center for Alcohol Policies, an organisation established and funded by large global alcohol producers, commissioned reports from scientists that resemble WHO documents. These reports were “incomplete, not subject to traditional peer review, and either supportive of industry positions or emphasizing high levels of disagreement among scientists”

The second strategy is to co-opt policy makers and health professionals. To undermine tobacco control research, the US Tobacco Institute promoted partnerships with scientists. They hired researchers and disseminated health promotion strategies to mislead the public about the harmful effects of smoking. Like the tobacco industry, the food and drink industry develops customers as young as possible, using tactics such as early-childhood health promotion schemes. SAB Miller and the International Center for Alcohol Policies have assisted the Lesotho, Malawi, Uganda, and Botswana Governments to write their national alcohol control policies. The four draft National Alcohol Policy documents were “almost identical in wording and structure and that they are likely to originate from the same source”,and were designed to “serve the industry’s interests at the expense of public health by attempting to enshrine ‘active participation of all levels of the beverage alcohol industry as a key partner in the policy formulation and implementation process’”

The third strategy is to lobby politicians and public officials to oppose public regulation. Tobacco transnationals lobby policymakers and fund campaigns of politicians who support tobacco use. The lobbying power of alcohol and ultra-processed food and drink corporations is also substantial. According to US Senate records, the largest alcohol companies spent $150 million lobbying compared with $40 million for tobacco between 1999 and 2011.58 US Senate Office of Public Records shows that PepsiCo alone reported spending more than $9 million in 2009 to lobby the US Congress. On the basis of filings with the Federal Elections Commission, in the 2008 election cycle, the company’s Political Action Committee so-called Concerned Citizen Fund alone contributed $547 700 to candidates for federal office. Its policy emphasises contributions to candidates who are “pro-business”, and who have a “commitment to improving the business climate” pending the “candidate’s position on key com mittees where legislation of importance to PepsiCo is considered”. In another example, the Sugar Association threatened WHO that it would lobby the US Government to withdraw its funding because WHO strategy on diet, physical activity, and health highlighted a strong link between sugar and NCD risk. Several people from these industries were billed in the official agenda of the September, 2011 UN high-level meeting on NCDs as the lead representatives of civil society, and gave keynote statements designed to guide policies. One was a former US Ambassador who is now Vice President, Global Public Policy and Government Affairs, at PepsiCo. The high-level meeting civil society list also included representatives from alcohol transnationals such as Diageo, SAB Miller, and Molson Coors Brewing.

The fourth strategy is to encourage voters to oppose public health regulation. For example, the tobacco industry has, and continues to campaign for, a restricted role of government, and against taxation and regulation. Their campaigns emphasise that tobacco use is an individual responsibility and raise arguments against so-called nanny state governments. Contrastingly, public health highlights the importance of social, economic, and political factors, and ethical considerations. The differences between high-risk individual and population approaches underline the gap between public health and industry perspectives. Similarly, blame-the-victim campaigns by transnational food corporations reduce public support for govern ment interventions. As an alternative to regulatory measures, alcohol and food industries promote ineffective individually-targeted information and educational approaches, and sometimes employ counter-productive covert marketing. Their social-marketing campaigns place responsibility for the purchasing decision on the individual, and in doing so, separate these choices from the circumstances in which they are made. The media regularly emphasise personal choice and responsibility and convey government intervention as coercive and oppressive. Despite the industries’ professed faith in these information-based approaches, they avoid disclosure of relevant health information to consumers. From the denial of tobacco addiction as late as 1994 to the obstruction of traffic-light labelling of unhealthy food and the recent detraction of alcoholic drinks from EU labelling legislation, the tobacco, alcohol, and food industries have all tried to block access to objective health information and to manipulate channels of communication. To deflect criticism, corporations promote actions outside their areas of expertise. For example, tobacco corporations promote the prevention of violence against women and ultra-processed food and drink corporations emphasise physical inactivity. Tobacco and alcohol producers also highlight illegal distribution and smuggling to deter policy makers from introducing regulation that will curtail their own activity. The similarities between strategies used by the tobacco, alcohol, and food and drink corporations are unsurprising in view of the flow of people, funds, and activities across these industries, which also have histories of joint ownership—eg, Philip Morris owned both Kraft and Miller Brewing; Altria is a lead shareholder in tobacco and food companies that have shared directorships; SAB Miller Board includes at least five past or present tobacco company executives and board members; and the Diageo Executive Director, responsible for public affairs, spent 17 years in a similar role at Philip Morris. Additionally, tobacco and food and drink corporations use the same public relations firms to lobby worldwide and to design stakeholder marketing campaigns such as Pernod Ricard’s drink Responsib’All Day. The alcohol and food and drink industries are united in intense opposition to the development of an equivalent to the WHO Framework Convention on Tobacco Control. Article 5·3 of this convention outlines the protection of public health policies for tobacco control from commercial and other vested interests of the tobacco industry and is relevant to the alcohol and ultra-processed food and drink industries. The actions of transnational corporations have generated such major concerns in the public health community,that there is now an emerging willingness to address these issues with scientific methods and systematic analysis.

The case for public regulation

The precautionary principle argues against public–private partnership because there is no evidence that the partnership of alcohol and ultra-processed food and drink industries is safe or effective, unless driven by the threat of government regulation. Similarly, there is little evidence that self-regulatory approaches are effective.

We believe that civil society should be aligned with government, which has the responsibility and power to protect public health, although compromised by transnational corporations. To fulfil this aim, governments need information and support from civil society and from public health interests. Regulation, or the threat of government regulation, is the only way to change transnational corporations; therefore, the audience for public health is government and not industry. Discussions with unhealthy commodity industries will be helpful only if they are with government and if the goal is for government to use evidence-based approaches. To respond to the scale and urgency of the global NCD epidemics, the industrial drivers that underpin them, and the tactics used by the unhealthy commodity industries so far, we have ten recommendations for action:

Recommendations of action for non-communicable diseases

For public health policy making, research, and programmes:

• Unhealthy commodity industries should have no role in the formation of national or international policy for non-communicable diseases
• Interactions with the tobacco industry should be restricted and made consistent with recommendations of the Framework Convention on Tobacco Control
• Discussions with unhealthy commodity industries should be with government only and have a clear goal of the use of evidence-based approaches by government
• In the absence of robust evidence for the effectiveness of self-regulation or private–public partnership in alcohol, food, and drink industry, rigorous, timely, and
independent assessment is needed to show that they can improve health and profit

For public health professionals, institutions, and civil society:

• Highly engaged, critical action is needed to galvanise an evidence-based constituency for change to implement effective and low-cost policies, to place direct pressure on industry to change, and to raise public awareness of the unhealthy effects of these industries
• Funding and other support for research, education, and programmes should not be accepted from the tobacco, alcohol, and ultra-processed food and drinks industries or their affiliates and associates

For governments and international intergovernmental agencies:

• Evidence-based approaches such as legislation, regulation, taxation, pricing, ban, and restriction of advertising and sponsorship should be introduced to reduce death and disability from non-communicable diseases

For governments, foundations, and other funding agencies:

• All approaches in the prevention and control of non-communicable diseases — ie, self-regulation, public–private partnerships, legislation, pricing, and other regulatory measures — should be independently and objectively monitored
• Funding of policy development research into modes of regulation and market interventions should be accelerated and prioritised
• A new scientific discipline that investigates industrial diseases and the transnational corporations that drive them, should be developed.

The first edition of the global Access to Nutrition Index (ATNI) report and rankings, was released on March 12, 2013. The report says that the world’s largest food and beverage manufacturers must do more to increase access to nutritious products and positively exercise their influence on consumer choice and behavior. The report assesses the nutrition-related commitments, performance and disclosure practices of 25 of the world’s largest food and beverage manufacturers as measured against international guidelines, norms and accepted best practices.

Unfortunately, on a 10-point scale, even the top three performers only scored about a 6, leaving much room for improvement for even the best of food and beverage compalnies. For example, even Danone and Nestlé, ranked 1st and 3rd respectively, hare in violation of the International Code of Marketing of Breast-milk Substitutes.

Inge Kauer, Executive Director of ATNI, says,”Obesity and undernutrition affect billions of people and threaten a global health catastrophe. The Access to Nutrition Index is an urgent call to action for food and beverage manufacturers to integrate improved nutrition into their business strategies. It is not only good for public health; it is a business imperative and key to their long-term sustainability.”

The three-year ATNI initiative was funded by the Global Alliance for Improved Nutrition (GAIN), the Bill & Melinda Gates Foundation and the Wellcome Trust. Development of ATNI was housed at GAIN and involved an extensive, multi-stakeholder process that included input from governments, international organizations, civil society, academia, and investors at every phase of the process. It was also guided by advice from an independent, multi-stakeholder advisory panel and a group of experts on nutrition. Company research and assessments were conducted by MSCI ESG Research using publicly available documents supplemented by additional information requested from each company.

ATNI evaluated companies on:

Corporate strategy, management and governance related to nutrition

Formulation and delivery of appropriate, affordable and accessible products

Positive influence on consumer choice and behavior

“The Access to Nutrition Index offers companies a comprehensive, independent assessment of how well their practices align with competitors in the food and beverage industry and provides benchmarks against which they can improve their approach to nutrition,” said Keith Bezanson, chair of the ATNI Independent Advisory Panel. “The aim is to promote a more objective public debate and encourage companies to do more to address nutritional needs of customers.”

Thirty-nine investment organizations which collectively manage more than USD 2.6 trillion in assets have signed a statement of support for the Index. The ATNI Investor Statement recognizes health and nutrition as drivers of future growth in the food and beverage sector, and that those manufacturers that are most effective in anticipating and responding to these factors will be better positioned to deliver superior and more sustained financial performance.

Key findings include:

The highest scoring companies have clear commitments, detailed policies and measurable targets related to nutrition. They have also charged senior executives with achieving these targets and provided incentives for them to do so.

Companies’ practices often do not measure up to their commitments. Companies are missing key opportunities to implement their commitments in core business areas such as product formulation, marketing and distribution.

Companies are not meaningfully engaged in addressing undernutrition and could better leverage their expertise, skills and scale to help combat this global health challenge.

The report challenges companies to:

Develop clear and measurable objectives and targets to improve nutrition. This is critical to ensuring that nutrition considerations become central to companies’ core business activities such as product development, pricing, distribution, and marketing.

Translate commitments to improve nutrition into action and develop mechanisms to track and monitor progress.

Increase public disclosure of nutrition activities. Such disclosure underpins credibility, strengthens any evaluation of their nutrition practices, and heightens accountability.

For companies that manufacture breast-milk substitutes, ensure full compliance with the International Code of Marketing of Breast-milk Substitutes in all countries.

Later this year, ATNI will also publish three Spotlight Indexes assessing 10 of the largest food and beverage manufacturers operating in India, Mexico and South Africa, respectively. The ATNI Global Index will be published every two years.

Here are the FAQS for the Access to Nutrition Index:

How can you compare these companies to each other when their product portfolios are so vastly different?

ATNI aims to evaluate the contribution all companies are making to improving consumers’ access to nutrition. This is determined by evaluating their efforts related to improving their product portfolio, how they support consumers in understanding what comprises a healthy diet and a healthy lifestyle, how they label their products, how they present them in marketing materials, offering a wide choice of products in varying sizes, and how they engage with governments and policymakers. Companies can improve their nutrition-related practices in all of these areas regardless of the composition of their product portfolios.

Has ATNI received financial contributions from industry for the development of the Index?

No. ATNI has a strict policy against accepting any financial contributions from companies or organizations that are part of the food and beverage industry.

Is this an investable index?

While ATNI is not intended to be an investable index, it does have the support of both investment managers and large institutional asset owners from around the world. ATNI has produced an Investor Statement in support of the Index, and its current signatories collectively manage over $2.6 trillion. ATNI is designed to be of value to them by providing insights into companies’ performance on nutrition issues which can be integrated into their financial analyses or used as a basis for engagements with companies on these critical issues.

When will the next Index be published?

The next global ATNI will be published in 2015.

How does ATNI’s scoring work? Is it absolute or relative?

Companies are scored on an absolute scale from 0 to 10 using a system that rewards good practices rather than penalizing poor ones.

A score of 0 indicates that no evidence was found for any nutrition-related commitments or practices.

A score of 10 signifies best practice as determined by consensus judgments against established international codes and guidelines and other norms set out in the ATNI assessment methodology.

Does ATNI address issues such as companies’ use of genetically modified organisms, impact on water and the environment, sourcing practices, and labor practices?

In this first version of the Index, ATNI confined its scope to those issues that are most important to improving access to nutrition.

As such, ATNI does not evaluate companies on other important ways in which they may have a social and/or environmental impact. Other ratings address some of these issues, such as Oxfam’s Behind the Brands Scorecard, which reviews the social and environmental impacts that ten large food and beverage companies are having on the food supply chain.

How does ATNI define which foods are healthy?

There is currently no universally accepted system for determining the nutritional quality of products relative to one another. As a result, there is no international standard for what can be considered a “healthy” product.

This creates inherent limitations on ATNI’s assessment of company practices as several indicators in the ATNI methodology depend on companies’ own definitions of “healthy” products, which can vary significantly.

A proxy approach is used in this version of the Index that assesses the quality of companies’ nutrient profiling systems – i.e., how companies determine the nutritional quality of their own products.

Does ATNI assess the nutritional quality of companies’ products?

Given the extremely large number and heterogeneity of products sold by companies assessed in the Global Index, it was not within the current scope of ATNI to profile the nutritional composition of companies’ products globally (or to identify a reasonably sized sample of products for profiling that would be sufficiently representative of their portfolios).

How can some companies with unhealthy product portfolios score so well on ATNI?

ATNI evaluates the contribution all companies are making to improving consumers’ access to nutrition around the world. This is determined both by efforts that companies have undertaken to improve the nutritional quality of their product portfolios and the efforts they make in many other aspects of their businesses, such as how they support consumers in understanding what comprises a healthy diet and a healthy lifestyle, how they label their products, how they present their products in marketing materials, offering a wide choice of products in varying sizes, and how they engage with governments and policymakers. Thus if a company with a seemingly less healthy portfolio receives a higher overall score on the ATNI, it is due to strong performance in other categories evaluated by the Index.

Could companies elect whether to be included in the Index?

Companies did not have a choice whether to be included in ATNI, which selected the world’s 25 largest companies by retail sales according to Datamonitor, a provider of proprietary global market research data (see Annex 1 in the 2013 Global Index report for more information on the methodology used to select companies to be assessed by ATNI).

Companies also could not pay to be evaluated (funding for ATNI was provided solely by GAIN, the Bill and Melinda Gates Foundation and the Wellcome Trust).

Companies had the option not to take part in the engagement phase of the research process. For companies that chose not to participate, their evaluation was based solely on publicly available information.

How should this information be used?

The results of ATNI allow for comparison of company performance on delivering better access to nutrition as measured against international guidelines and expert guidance.

Companies (including both those ranked and not ranked by ATNI) may use this information to benchmark their performance against peers or to help guide their agenda for nutrition activities.

Investors may use this information to guide their engagement with companies and/or investment decisions.

Norm-setting bodies may use this information as an input into guideline development, including the identification of areas which currently lack such guidance.

Policymakers may use this information to identify areas in need of industry-wide improvement which may be amenable to regulatory intervention.

Civil society organizations may use this information to guide their advocacy efforts.

Academics may use this information to identify areas in need of further research.

Media organizations may use this information to draw attention to priority, or otherwise under-recognized, issues.

Who developed ATNI?

The Access to Nutrition Index was developed by a team based at the Global Alliance for Improved Nutrition, with the support of The Bill & Melinda Gates Foundation and the Wellcome Trust, and under the guidance of two multi-stakeholder bodies. An Expert Group advises on the development of the company assessment methodology. Separately, an Independent Advisory Panel (including representatives from each the three funding organizations) provides strategic advice on the development of ATNI. To ensure objectivity, neither body includes anyone currently employed by the food and beverage manufacturing industry. In the future, ATNI will be operated outside of GAIN by a separate stand-alone organization.

Why create this Index?

This Index underscores the important role of food and beverage manufacturers in addressing obesity and undernutrition, both of which are among the world’s most pressing public health concerns. These public health challenges affect billions of people, and efforts to address them are vital to ensure that people around the world can live healthy and productive lives. There is currently no other systematic effort to compare companies’ contribution to addressing global nutrition challenges in a consistent way. The Index provides all those concerned with addressing obesity and undernutrition with an objective picture of what companies are already doing and where they can improve and highlights good practices across the industry.

Why have you included the BMS companies in the assessment? Shouldn’t they have been given zero score or been excluded from the Index altogether?

ATNI is designed to assess the overall contribution companies make to preventing and addressing obesity and diet-related chronic diseases and to undernutrition. While we recognize the critical importance of supporting and promoting breastfeeding, ATNI has chosen to include BMS companies and assess whether they comply with the International Code, according to material published by IBFAN, rather than to exclude them. This enables comparison with their competitors who do not manufacture BMS.

The federal Centers for Disease Control and Prevention (CDC) has reported that obesity has been rising, even though Americans are consuming fewer calories. This seems puzzling to many. Changes in physical activity, the amount of calories burned, doesn’t appear to explain this discrepancy. As stated by the co-author of the study, Dr. William Dietz, former CDC director of Nutrition, Physical Activity and Obesity, “It’s hard to reconcile what these data show, and what is happening with the prevalence of obesity.”

However, evidence is growing that chemicals in our food, water, and environment may be changing our bodies’ hormonal balances and metabolism. Such chemicals are called endocrine disruptors. When linked to hormonal disorders linked to obesity they are called obesogens (literally, “causer of obesity”) — see here for more on the obesogen hypothesis.

A recent scientific review summarizes data from experimental animals and humans which support an association of endocrine disrupting chemicals, such as diethylstilbestrol, bisphenol A, phytoestrogens, phthalates, and organotins, with the development of obesity. The reviewers state, “The reasons for this sharp increase in overweight/obesity are not well understood but factors such as high fructose diets, genetics/epigenetics, increased maternal age, sleep debt, use of certain pharmaceuticals, and the built environment have all been proposed as playing a role.” They conclude:

“The data included in this review support the notion that brief exposure early in development to environmental chemicals with estrogenic activity increases body weight gain with age and alters markers predictive of obesity in experimental animals. Furthermore, epidemiologic studies support the findings in experimental animals and show a link between exposure to environmental chemicals (such as estrogenic chemicals, BPA, PCBs, DDE, and persistent organic pollutants and heavy metals) and the development of obesity.Importantly, the use of soy-based infant formula containing the estrogenic component genistein has been positively associated with obesity later in life. Using the DES animal model as an important research tool to study “obesogens”, the mechanisms involved in altered weight homeostasis (direct and/or through endocrine feedback loops, i.e., ghrelin, leptin, etc.) by environmental estrogens can be elucidated. In addition, this animal model may shed light on areas of prevention. Public health risks can no longer be based on the assumption that overweight and obesity are just personal choices involving the quantity and kind of foods we eat combined with inactivity. It is quite possible that complex events, including exposure to environmental chemicals during development, may be contributing to the obesity epidemic.”

It’s official: sugar causes diabetes. While this may seem intuitive, it has been debated for decades. Now, a new study, using data from 175 countries over the last decade, shows that sugar is an independent risk factor for diabetes. Sugar consumption explains variations in diabetes that are not explained by physical activity, overweight or obesity. The sugar-diabetes link holds true even when considering total calories, food types (including fibers, meats, fruits, oils, cereals, alcohol), and several socioeconomic variables such as aging, urbanization and income.

The level of scientific confidence here is as strong as that which linked cigarettes and lung cancer in the 1960s. Of course, we know that it took decades for the tobacco industry to actually admit the connection. Hopefully, the sugar and food industries will not be so recalcitrant.

So, what’s the size of this effect? For the every equivalent of 12 ounces of sugar-sweetened beverage introduced per person per day into a country’s food system, the rate of diabetes goes up 1 percent.

For more on the what this means for food industry and health politics, check out this article: It’s the Sugar, Folks

Ready for a big shake-up of the world’s largest food and beverage companies? Here it comes! The international relief and development organization Oxfam America has launched a new global campaign called ‘Behind the Brands’. The campaign scores and ranks the agricultural policies, public commitments and supply chain oversight of Associated British Foods, Coca Cola, Danone, General Mills, Kellogg, Mars, Mondelez, Nestlé, Pepsico and Unilever. The “Big 10” food and beverage companies together make $1 billion-a-day while failing millions of people in developing countries who supply land, labor, water and commodities needed to make their products.

Raymond C. Offenheiser, President,. Oxfam America, says, “It’s time these companies take more responsibility for their immense influence on poor people’s lives. Eighty percent of the world’s hungry people work in food production and these companies employ millions of people in developing countries to grow their ingredients. They control hundreds of the world’s most popular brands and have the economic, social and political clout to make a real and lasting difference to the world’s poor and hungry.”

“In Pakistan, rural communities say Nestlé is bottling and selling valuable groundwater near villages that can’t afford clean water. In 2009, Kraft was accused of purchasing beef from Brazilian suppliers linked to cutting down trees in the Amazon rainforest in order to graze cattle. And today, Coca-Cola is facing allegations of child labor in its supply chain in the Philippines.

Sadly, these charges are not anomalies. For more than 100 years, the world’s most powerful food and beverage companies have relied on cheap land and labor to produce inexpensive products and huge profits. But these profits have often come at the cost of the environment and local communities around the world, and have contributed to a food system in crisis.

Today, a third of the world’s population relies on small-scale farming for their livelihoods. And while agriculture today produces more than enough food to feed everyone on earth, a third of it is wasted; more than 1.4 billion people are overweight, and almost 900 million people go to bed hungry each night.

The vast majority of the hungry are the small-scale farmers and workers who supply nutritious food to 2–3 billion people worldwide,6 with up to 60 percent of farm laborers living in poverty. At the same time, changing weather patterns due to greenhouse gas emissions – a large percentage of which come from agricultural production – are making farming an increasingly unreliable occupation.

Adding to the vulnerability of poor farmers and farm workers, food prices continue to fluctuate wildly, and demand for soy, corn, and sugar to feed affluent diets is on the rise. And to top it off, the very building blocks of the global food system – fertile land, clean water, and reliable weather – are growing scarce.

These facts are not secrets; companies also realize that agriculture has grown risky and are taking steps to guarantee future commodity supplies and to reduce social and environmental risks along their supply chains.

Today, food and beverage companies speak out against biofuels, build schools for communities and cut back on water usage in company operations. New corporate social responsibility programs are proliferating and declarations of sustainability are now ubiquitous. The CEO of PepsiCo, Indra Nooyi, in fact noted in 2011, ‘It is not enough to make things that taste good. PepsiCo must also be “the good company.” It must aspire to higher values than the day-to-day business of making and selling soft drinks and snacks.’

But such claims of better environmental and social behaviour have thus far been extremely difficult to assess, despite rapidly growing consumer demand to know the truth of these claims.

Now, Oxfam’s Behind the Brands campaign evaluates where companies stand on policy in comparison with their peers and challenges them to begin a ‘race to the top’ to improve their social and environmental performance. By targeting specific areas for improvement along the supply chain, the campaign pinpoints policy weaknesses and will work with others to shine a spotlight on the practices of these companies

Behind the Brands is a part of the GROW campaign. Oxfam’s GROW campaign aims to build a better food system: one that sustainably feeds a growing population (estimated to reach nine billion people in 2050) and empowers poor people to earn a living, feed their families and thrive.

Oxfam’s campaign focuses on 10 of the world’s most powerful food and beverage companies – Associated British Foods (ABF), Coca-Cola, Danone, General Mills, Kellogg, Mars, Mondelez International (previously Kraft Foods), Nestlé, PepsiCo and Unilever – and aims to increase the transparency and accountability of the ‘Big 10’ throughout the food supply chain.

At its core, the campaign features the Behind the Brands scorecard. The scorecard examines company policies in seven areas critical to sustainable agricultural production, yet historically neglected by the food and beverage industry: women, small-scale farmers, farm workers, water, land, climate change, and transparency.

According to the scorecard rankings, Nestlé and Unilever are currently performing better than the other companies, having developed and published more policies aimed at tackling social and environmental risks within their supply chains. At the other end of the spectrum, ABF and Kellogg have few policies addressing the impact of their operations on producers and communities.

Yet the scorecard also clearly shows that all of the Big 10 – including those which score the highest – have neglected to use their enormous power to help create a more just food system. In fact, in some cases these companies undermine food security and economic opportunity for the poorest people in the world, making hungry people even hungrier.

Behind the Brands reveals that the social responsibility and sustainability programs which companies have implemented to date are typically tightly focused projects to reduce water use or to train women farmers, for example. But these programs fail to address the root causes of hunger and poverty because companies lack adequate policies to guide their own supply chain operations.

Important policy gaps include:
• Companies are overly secretive about their agricultural supply chains, making claims of ‘sustainability’ and ‘social responsibility’ difficult to verify;
• None of the Big 10 have adequate policies to protect local communities from land and water grabs along their supply chains;
• Companies are not taking sufficient steps to curb massive agricultural greenhouse gas emissions responsible for climate changes now affecting farmers;
• Most companies do not provide small-scale farmers with equal access to their supply chains and no company has made a commitment to ensure that small-scale producers are paid a fair price;
• Only a minority of the Big 10 are doing anything at all to address the exploitation of women small-scale farmers and workers in their supply chains.

Although the Big 10 food and beverage companies consider themselves limited by fiscal and consumer demands, they do in fact have the power to address hunger and poverty within their supply chains. Paying adequate wages to workers, a fair price to small-scale farmers, and assessing and eliminating the unfair exploitation of land, water and labor are all steps which clearly lie within the means of these hugely powerful companies.

Oxfam’s Behind the Brands campaign encourages companies to reassess ‘business as usual’ and instead begin a race to the top; a healthy competition among the Big 10 to ensure a more sustainable and just food system for all.”

BPA is a hormone disruptor, of which infants and children are particularly susceptible. BPA is found in canned foods and polycarbonate bottles. Look for the recycling numbers 3 and 7 for its presence. BPA leaching is greatly sped up with heat, so don’t heat food in the microwave in plastic containers or on plastic plates.

The World Health Organization (WHO) just came out with a report calling hormone disruptors a “global threat.” The co-author of the report, Thomas Zoeller, a professor at the University of Massachusetts, Amherst, tells us, “Frankly, for BPA, the science is done. Flame retardants, phthalates . . . the science is done . . . We have more than enough information on these chemicals to make the reasonable decision to ban, or at least take steps to limit exposure.”

Supplementing with vitamins and minerals is a tricky subject. The most recent scientific review recommends that healthy women NOT take calcium and vitamin D supplements to prevent bone fractures. BOTTOM LINE: No evidence for benefit, some health risk.

My recommendation for bone health: bones are like muscle mass — USE IT OR LOSE IT! Get plenty of physical activity, and even some sunshine to get your vitamin D!

A good default principle applicable to nutrition supplementation is the precautionary principle:

“if an action or policy has a suspected risk of causing harm to the public or to the environment, in the absence of scientific consensus that the action or policy is harmful, the burden of proof that it is not harmful falls on those taking an act. This principle allows policy makers to make discretionary decisions in situations where there is the possibility of harm from taking a particular course or making a certain decision when extensive scientific knowledge on the matter is lacking. The principle implies that there is a social responsibility to protect the public from exposure to harm, when scientific investigation has found a plausible risk. These protections can be relaxed only if further scientific findings emerge that provide sound evidence that no harm will result.

In some legal systems, as in the law of the European Union, the application of the precautionary principle has been made a statutory requirement.” (Wikipedia)

Pasta with tomato sauce is a common meal that can be very nutritious. Plus, the nutritional value can be boosted very easily, with just a few tricks.

Tomato sauce is one of the best nutrition buys that is easily available and widely used. Tomatoes have two uncommon characteristics that should earn them a place as a staple in your diet. First, tomatoes are packed with a rare and powerful antioxidant (lycopene) that helps prevent heart disease, cancer, and likely a whole host of other health problems. Second, tomatoes have a savory taste, making them taste boosters. Many people are aware that people have four basic tastes of sweet, salty, bitter and sour — but savory is a fifth taste! Unfortunately, savory taste compounds are relatively uncommon in the average diet. Tomatoes and mushrooms are two common foods which add savory taste (you can probably guess where that is going!).

When choosing a jar or can of tomato sauce, check the nutrition label for sugar and sodium. Choose a variety with a lower sugar and sodium content. If you find a variety that you like on sale, stock up on it, it will store very well. If you make your own sauce from tomato paste or fresh tomatoes you can leave the sugar out and control the salt content.

Next, power up your tomato sauce! This is easy to do with oregano, garlic, onion, mushroom, and balsamic vinegar. Dried oregano has the highest antioxidant content per serving of any commonly used spice. Just add a couple of tablespoons! Onions and garlic both come from a plant family offering powerful health benefits: anti-heart disease, anti-cancer, and anti-microbial. The easiest boost is to add chopped garlic (I keep a jar in the refrigerator at all times). If you have the time, sauté a chopped onion or two, along with chopped garlic. Sautéing in olive oil is both a tasty and nutritious choice. If you are going to use mushrooms, go ahead and add those as well. If you are using canned mushrooms, you can add the “juice”, so you don’t throw out a bunch of those water-soluble nutrients (and flavor). You can also add other vegetables, such as green peppers, to boost nutrition and flavor. Adding a dash of balsamic vinegar will help create a rich, meaty flavor and additional nutrition. I like adding ground red pepper for even more nutritional and taste punch. Hot pepper is particularly useful if you are using/making lower salt tomato sauce.

To pack the biggest punch, eat a lot of sauce with your pasta, particularly if you are resorting to refined grain pasta. I would strongly recommend using whole wheat pasta. The nutritional value of whole grains versus refined grains is incomparable. It’s somewhat more expensive, but well worth it nutritionally. If you are not used to the taste, give it a try; it’s something your tastes can adapt to over time (if you are not willing to use whole wheat pasta, using whole wheat bread in your diet might offer an easier start). When boiling pasta, don’t use excessive water, since water soluble vitamins, minerals and phytonutrients leech out (or you can use the leftover water for other cooking).

Nature knows best. Eating foods in a form that resembles the state in which they were harvested is a good bet for optimizing a food’s nutritional value. “Whole” means that the food’s original nutritional potential is substantially present by the time they get in your mouth. “Whole” refers to the basic foodstuffs from nature. The nutritional value and quality of basic foodstuffs depends upon many things, including:

1) the genetics of the foodstuff (plant, animal, fungus, or variety thereof);
2) the inputs which make food grow, such as soil, water, air, sun, and fertilizer (and feed for animal foods); and
3) the larger ecology, including weather, symbiotic organisms, weeds, or pests.

“Minimally processed” means that the food is processed only as much as is necessary to:

1) enhance nutritional availability;
2) prevent the loss of nutritional value;
3) assure that the food is safe; and
4) make the food palatable.

Your body requires a wide variety of nutrients. Meeting your body’s nutrient requirements is best achieved by eating a wide variety of wholesome foods. Mix it up! Many compounds in our diets interact with one another, often with great synergy. Mixing it up can make the sum greater than the parts. Be wary of fad diets that greatly restrict your food variety or focus on a small number of foods or nutrients. Your body is awesome at maintaining “homeostasis” — a fancy word for balance — it just needs a sensible input of wholesome foods.

3. Eat mostly plant foods.

Plant foods offer a wider variety and better mix of health-forming nutrients than animal foods. Much of this is due to a large number and quantity of positively bioactive phytonutrients present in plants. However, animal foods also contain substantial components which are disease-forming. Also, foods higher up the food chain, i.e., all animal foods, tend to bioaccumulate toxins such as heavy metals and fat-soluble chemicals. In modern, industrialized diets, higher animal food consumption is associated with poorer health.

4. Eat and drink in moderation.

Moderation is a close relative of variety. Moderation and variety are practices that support balance. For most people, balance means eating more good foods and less “bad” foods. If indulging in “bad” foods, do so in moderation. Eliminating your favorite foods may do more harm than good, if it does not allow you to make sustainable changes to your diet. Small changes over time add up! And, even with the best foods, it is possible to get too much of a good thing. As they say, “The dose makes the poison.”

5. Eat regular meals.

Your body functions better when your food intake is spread out across three meals a day. Breakfast is key to priming your metabolism and getting an energetic start to your day. Snacking between meals probably adds little additional benefit, and may be detrimental to oral health. Drinking water between meals may be a good habit to stay hydrated (unsweetened, plain coffee/tea can be a healthy source of antioxidants — though you may want to avoid caffeine 10 hours before bedtime).

6. Eat ecologically-sustainable foods.

All life is interdependent. What we eat not only affects our nutritional status, it affects our planet and all life that depends on it. Ecologically-sustainable foods are part of a healthy, sustainable food system. A healthy, sustainable food system emphasizes, strengthens, and makes visible the interdependent and inseparable relationships between individual sectors (from production to waste disposal) and system characteristics (health-promoting, sustainable, resilient, diverse, fair, economically balanced, and transparent). This benefits all farmers, workers and eaters involved, as well as the planet and its other inhabitants. Explore more at Eating Ecologically.

7. Pay attention to what you eat.

Paying attention, or mindfulness, is key to actively participating as a just eater on an interdependent planet. Mindfulness is the foundation for accurately assessing what you actually eat. Once you know what you are eating, then you can properly evaluate what impact your food has on you and your planet.

8. Pay attention to your eating habits.

Just eating is way more than just knowing the nutritional value of what you are eating. Where does your food come from? How does it get to you? Where did you buy it? How much does it cost? Where do you eat it? How was it prepared? What are your regular eating habits? Why do you eat the way you do? Being mindful of your eating habits can give you important clues to what improvements may be made.

9. Pay attention to the feedback of your body (and mind).

Your body is amazing! Whether you are paying attention or not, your body is busy processing the food you eat and the nutrients it absorbs. Your body is orchestrating gazillions of chemical reactions every second to keep in you balance. Return the favor and pay attention to your body (and mind)! This can help you decipher signals and cues related to taste, hunger, thirst, alertness, fatigue, and emotional state that can impact your food choices. Teaming up with your body can be the beginning of a long and healthy relationship.

10. Enjoy your food!

Food is one of the great pleasures in life! If food and nutrition become a chore, then you may be missing the point. Health is for life. Life is for enjoying! Becoming enlightened about food and nutrition may “ruin” some eating habits for you. There is a certain amount effort and even distress involved in disciplines leading to enlightenment. Nonetheless, the payoff can be greater harmony within yourself and your environment. This is a cause for joy!

In June 2010, the Academy of Nutrition and Dietetics (formerly American Dietetics Association), American Nurses Association, American Planning Association, and American Public Health Association initiated a collaborative process to develop a set of shared food system principles. The following principles are a result of this process and have been collectively endorsed by these organizations.

We support socially, economically, and ecologically sustainable food systems that promote health – the current and future health of individuals, communities, and the natural environment.

A healthy, sustainable food system is:

HEALTH-PROMOTING

• Supports the physical and mental health of all farmers, workers and eaters
• Accounts for the public health impacts across the entire lifecycle of how food is produced, processed, packaged, labeled, distributed, marketed, consumed and disposed

SUSTAINABLE

• Conserves, protects, and regenerates natural resources, landscapes and biodiversity
• Meets our current food and nutrition needs without compromising the ability of the system to meet the needs of future generations

RESILIENT

• Thrives in the face of challenges, such as unpredictable climate, increased pest resistance, and declining, increasingly expensive water and energy supplies

DIVERSE IN

• Size and scale—includes a diverse range of food production, transformation, distribution, marketing, consumption, and disposal practices, occurring at diverse scales, from local and regional, to national and global
• Geography—considers geographic differences in natural resources, climate, customs, and heritage
• Culture—appreciates and supports a diversity of cultures, socio-demographics, and lifestyles
• Choice—provides a variety of health-promoting food choices for all

FAIR

• Supports fair and just communities and conditions for all farmers, workers and eaters
• Provides equitable physical access to affordable food that is health promoting and culturally appropriate

ECONOMICALLY BALANCED

• Provides economic opportunities that are balanced across geographic regions of the country and at different scales of activity, from local to global, for a diverse range of food system stakeholders
• Affords farmers and workers in all sectors of the system a living wage

TRANSPARENT

• Provides opportunities for farmers, workers and eaters to gain the knowledge necessary to understand how food is produced, transformed, distributed, marketed, consumed and disposed
• Empowers farmers, workers and eaters to actively participate in decision-making in all sectors of the system

A healthy, sustainable food system emphasizes, strengthens, and makes visible the interdependent and inseparable relationships between individual sectors (from production to waste disposal) and characteristics (health-promoting, sustainable, resilient, diverse, fair, economically balanced, and transparent)
of the system.